| NPI | 1164030409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 374U00000X Home Health Aide |
| Additional Taxonomies | 171W00000X Contractor |
| 171WH0202X Contractor, Home Modifications | |
| 2279P4000X Respiratory Therapist, Registered, Patient Transport | |
| Enumeration Date | 2020-07-22 |
| Last Update Date | 2020-09-04 |